Major depressive disorder is a mental disorder characterized by a pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. The term “major depressive disorder” (which is also known as clinical depression, major depression, unipolar depression, or unipolar disorder) was selected by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classification, and has become widely used since.
The general term depression is often used to describe the disorder, but as it is also used to describe a depressed mood, more precise terminology can be used in clinical and research use. Major depression is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, approximately 3.4% of people with major depression commit suicide, and up to 60% of all people who commit suicide have depression or another mood disorder.
The diagnosis of major depressive disorder is based on the patient's self-reported experiences, behaviour reported by relatives or friends, and a mental status exam. There is no laboratory test for depression, although physicians generally request tests for physical conditions that may cause similar symptoms. The most common time of onset is between the ages of 30 and 40 years, with a later peak between 50 and 60 years. Depression is reported about twice as frequently in women as in men, although men are at higher risk for suicide.
Most patients are treated in the community with antidepressant medication and some with psychotherapy or counseling. Hospitalization may be necessary in cases with associated self-neglect or a significant risk of harm to self or others.
A minority are treated with electroconvulsive therapy (ECT), under a short-acting general anaesthetic.
The course of the disorder varies widely, from one episode lasting months to a lifelong disorder with recurrent major depressive episodes. Depressed individuals have shorter life expectancies than those without depression, in part because of greater susceptibility to medical illnesses. Current and former patients may be stigmatized.
The understanding of the nature and causes of depression has evolved over the centuries, though many aspects of depression remain incompletely understood and are the subject of discussion and research.
Anxiety Disorder or Generalised Anxiety Disorder (GAD) is a disorder that causes sufferers to constantly feel anxious about a range of situations or issues. The term “anxiety” can relate to both physical and mental symptoms (such as physical tension and mental apprehension). Constant anxiety can often lead to patient's suffering from stress, loss of concentration and sleep deprivation.
Anxiety disorders are often comorbid with other mental disorders, particularly clinical depression i.e. major depressive disorder. There is therefore a need for a way of diagnosing these diseases in order to identify those in need of treatment.
Recent studies have indicated immune dysregulation in persons with depressive and anxiety disorders. By examining the expression of cytokines in response to ex vivo stimulation of blood by lipopolysaccharide (LPS), the innate production capacity of cytokines in depression and anxiety can be studied.